title: Womens experiences of HIV testing and counselling in the labour ward: a case of Bwaila hospital.
abstract: BACKGROUND
  HIV counseling and testing during labour can be emotional, but is important because it allows mothers and babies to receive PMTCT prophylaxis if previous identification of HIV infection has not occurred. The study explores how HIV testing and counseling during early labour affects women.
  
  
  METHODS
  This was a qualitative exploratory study to understand women's experiences during early labor. From September to October 2009, we conducted 10 indepth interviews with women who tested for HIV during early labour. We recruited women who tested > 3 months previously and those who had never tested for HIV from the postpartum ward of Bwaila Hospital. Data were analyzed manually using the life story approach in order to examine and analyse subjective experiences of women and their constructions of the social world. Transcripts were read multiple times to understand meanings which participants attached to their experiences. We coded data according to emerging themes and subthemes.
  
  
  RESULTS
  Ten women 20-35 years were interviewed. Eight women had unknown HIV status while two had known HIV results but re-tested to update their status. Four women were found HIV-positive while 6 were HIV-negative. The primary theme was that women appreciated and accepted HIV testing and counseling. Testing was accepted as a necessary step to protect the infant from HIV infection. Counseling was viewed as helpful for acceptance of HIV status. One key subtheme was that HIV positive women experienced disappointment about their HIV diagnosis, though this was outweighed by the knowledge that one could protect her infant. All women viewed the short time to complete the counseling and testing procedures as favourable.
  
  
  CONCLUSIONS
  Labour testing is acceptable and should be promoted to enhance PMTCT services by identifying HIV positive women with unknown status. Counseling helps women to accept being found with HIV and seek appropriate services.
authors.affiliation: University of North Carolina Project, Lilongwe Malawi.
authors.forename: G
authors.initials: G
authors.lastname: Hamela
authors.forename: T
authors.initials: T
authors.lastname: Tembo
authors.forename: N E
authors.initials: NE
authors.lastname: Rosenberg
authors.forename: I
authors.initials: I
authors.lastname: Hoffman
authors.forename: C
authors.initials: C
authors.lastname: Lee
authors.forename: M
authors.initials: M
authors.lastname: Hosseinipour
mesh_terms: D000328:Adult; D003376:Counseling; D036861:Delivery, Obstetric; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000523:psychology / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007407:Interviews as Topic; D007743:Labor, Obstetric; D008403:Mass Screening / Q000379:methods; D009035:Mothers / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000523:psychology; D036301:Qualitative Research; D055815:Young Adult